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Report 7409 SW Tech Center Dr,Ste. 145 Tigard,OR 97223 411=""' '" Ph:503-443-3799 Fax:503-620-2748 OnV ri1tfsv,,.,*( 503.443.3799 Special Inspection Final Report Date: 8-20-13 Job# 13-4255-D35 Permit#BUP2013-00188 Mail To: Project: NORTHWEST HANDLING SYSTEMS PCC-CENTRAL DISTRIBUTION 18008 NE AIRPORT WAY 671NITA RD STE 200 PORTLAND,OR 97210IT CARD,OR 97224 JOB#03ER130628C To Whom It May Concern: ACS Testing, Inc.attests that their inspectors performed special inspection(s)on a continuous and/or Periodic basis as required by the specific jurisdiction and/or IBC. Special inspection(s)were performed For the following: Proprietary Anchors-Expansion Based on personal observation, inspection and reports reviewed by me for the above project, I attest on behalf of ACS that work was performed to the best of my knowledge, in accordance with approved plans, specifications,and the applicable codes and standards for the jurisdiction. -to‘e)')(314(ANA-- Approved by: Bob Brown/President BB/sa t Proud to be Nationally Accredited by International Accrediting Service ACCREDITED 7409 SW Tech Center Dr.Ste. 145 Tigard,OR.97223 spar Ph:503-443-3799 Fax:503-620-2748 TE DAILY FIELD REPORT FOR PROPRIETARY ANCHORS OHS TESTING,INC 503.4f3.3799 Date: 8/12/2013 Permit#: BUP2013-00188 NORTHWEST HANDLING PCC-CENTRAL DISTRIBUTION Continuous 6713 BONITA RD STE 200 SYSTEMS 18008 NE AIRPORT WAY TIGARD, OR 97224 Periodic PORTLAND, OR 97210 ,/ JOB#03ER130628C INSPECTOR/CERT Jason Brown 1018 ACS Job # 13-4255-D35 Anchor Embedded in: Concrete IS THIS A REINSPECTION?: f Yes 111 No Compressive Strength: EXISTING UNKNOWN APPROVED PLANS AVAILABLE ✓ Yes ❑ No HOLE DETAIL/CONDITION WORK ACCEPTABLE PER APPROVED PLANS: C Yes ( No ANCHO HOLE HOLE Installation complies with RSIZE: 1/2" DIA. 1/2" DEPT 3" + 0Yes I No H: manufacturers evaluation report? Holes cleaned properly?: ✓❑ Yes n No LOCATION OF ANCHORS Hole depth per plans?: ❑✓ Yes n No GRIDLINES New racking in PCC warehouse ESRINSTALLATION REPORT# GRIDLINES ESR-1917 TZ CARBON &STAINLESS IN CONCRETE GRIDLINES TYPE OF ANCHOR: WEDGE ANCHOR IS THERE AN RFI? ❑ Yes ✓ No EPDXY TYPE: N/A RFI ATTACHED? Yes n No INSPECTION DETAILS: Exp.Date: N/A ACS Testing arrived on site for periodic inspection of the 1/2"HILT KW K bolt TZ wedge anchors per note 5 on drawing 13-0982-A using two for each base plate placed diagonally with a minimum embedment of 2-1/2 inches per detail 3 on drawing 13-0982-A. Torque test performed at 40 ft/lbs per ESR-1917.The work performed appears to be in conformance with ESR-1917 and the approved plans. Latest revision #0 issue for permit 06/12/2013. Foreman notified of 0 Yes 0 No ✓] NA nonconformance items? Foremans Name: Tom Revieweda i 3t Date: CC: OS-13-2013 Nathan Buhl,Jerry Griffith BB/JB Bob Brown,President �..r- ACCREDITED